Emami Habib, Modarressi Taher, Najmi Kosar, Radmand Golnar, Monjazebi Fatemeh, Tabarsi Payam, Richter Jörg
Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, Massachusetts General Hospital.
Tanaffos. 2015;14(3):182-92.
Tuberculosis (TB) is one of the most challenging public health burdens in the world. Recent research demonstrated high prevalence of mental disorders in TB patients and their caregivers. The purpose of this study was to assess mental health of TB patients and their caregivers in Iran before and after a two-week inpatient treatment and to determine the prevalence of psychological problems in these groups.
A standardized questionnaire (SCL-90) was used to assess psychological symptoms in 146 hospitalized TB patients and their caregivers (n=89). Furthermore, the scores of both target groups were compared with those of a group of healthy individuals (n=85).
The mean scores before the start of the initial treatment of the patients were significantly lower for paranoid ideation (P=0.038) and hostility (P= 0.046), and the scores of depression (P=0.046) and somatization (P=0.001) were significantly higher than those of the healthy individuals. The patients scored significantly higher than the caregivers on depression (0.047) and somatization (P< 0.001), whereas the caregivers scored higher than the healthy individuals on paranoid ideation (P= 0.044) and hostility (P= 0.034). Multiple linear regression showed that age, educational level and marital status were factors affecting the mental health of TB patients and their caregivers. The variance in psychological symptoms of the patients was between 10% (paranoid ideation) and 27% (hostility) of the variance in the symptoms of their caregivers.
Tuberculosis control and treatment programs should not only address issues like continued respiratory symptoms, but should also focus on mental health in TB patients and their caregivers.
结核病是全球最具挑战性的公共卫生负担之一。近期研究表明，结核病患者及其照料者中精神障碍的患病率很高。本研究的目的是评估伊朗结核病患者及其照料者在为期两周的住院治疗前后的心理健康状况，并确定这些群体中心理问题的患病率。
采用标准化问卷（症状自评量表90项，SCL-90）评估146例住院结核病患者及其89名照料者的心理症状。此外，将两个目标组的得分与一组健康个体（85名）的得分进行比较。
患者初始治疗开始前，偏执观念（P = 0.038）和敌对性（P = 0.046）的平均得分显著低于健康个体，而抑郁（P = 0.046）和躯体化（P = 0.001）得分显著高于健康个体。患者在抑郁（P = 0.047）和躯体化方面的得分显著高于照料者（P < 0.001），而照料者在偏执观念（P = 0.044）和敌对性方面的得分高于健康个体（P = 0.034）。多元线性回归显示，年龄、教育水平和婚姻状况是影响结核病患者及其照料者心理健康的因素。患者心理症状的方差在其照料者症状方差的10%（偏执观念）至27%（敌对性）之间。
结核病控制和治疗项目不仅应解决持续呼吸道症状等问题，还应关注结核病患者及其照料者的心理健康。
